Managing Deep Mycoses in Nepal is still a challenge: case report of actinomycetoma, a neglected tropical disease

Abstract

Deep mycoses are frequent diagnoses in Nepal. Most of the cases remain undiagnosed because of unavailability of specific diagnostic services in our setting. We report a case of deep mycosis, in a 60-year-old male, who presented with multiple nodules and scars on his neck and chest, and was histopathologically diagnosed as actinomycosis. The culture was negative. The patient did not respond to treatment with penicillin initially, however, on starting co-Trimoxazole , the lesions resolved in two months, thus pointing towards diagnosis of actinomycetoma. The patient remained disease free at last follow- up at two years. The case highlights importance of considering actinomycetoma as one of the differential diagnosis of such presentation and also need of developing well set reference laboratory in order to reach to a proper diagnosis.